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DAVID R. MARKS, MD: Hi, and welcome to our webcast. I'm Dr. David Marks. Since it was invented, the internal penile pump has helped more than 250,000 men suffering from erectile dysfunction. Choosing this option is a major decision, and men want to know how it's going to affect their daily lives, how it's going to affect their sex life in the long term. They have lots of questions about long-term satisfaction with this device.
We're going to talk about that today, and we're lucky to have a number of guests who know a lot about it. First is Dr. François Eid. He is a urologist in private practice and the Director of Advanced Urological Care in Manhattan. Thanks for being here.
J. FRANÇOIS EID, MD: Thank you, David.
DAVID R. MARKS, MD: We're also very fortunate to have two patients who we last saw 18 months ago. They had the procedure done just prior to coming on the webcast at that time, so we're going to kind of see what it's like 18 months after the procedure. They are off camera, and their names are John and Jim. Thank you for being here. We also have John's partner, so we're going to see from the partner's perspective the long-term satisfaction with the device.
So, François, tell us, this is a very successful procedure, isn't it?
J. FRANÇOIS EID, MD: Yes.
DAVID R. MARKS, MD: What are the success rates?
J. FRANÇOIS EID, MD: Very high. Above 90% of patients who get one of these are very satisfied, and we can pretty much guarantee that every device will work.
DAVID R. MARKS, MD: Now, when you say "satisfied," what do you mean by that?
J. FRANÇOIS EID, MD: They're able to have sex whenever they want to have sex, that they're able to reach orgasm, that they can satisfy their partner, that essentially they feel normal.
DAVID R. MARKS, MD: Let's hear from the patients now. John, how satisfied have you been? Are you happy?
JOHN: Absolutely. In fact, I don't even think about it, because it's so natural. Yes, it's not only happy, but it's extremely natural. Feelings are normal.
DAVID R. MARKS, MD: So sex is normal now? It's the same now as it was prior to the procedure 18, 19 months ago?
JOHN: Absolutely. I think it's probably enhanced a bit. But that's not the reason for the pump, but it does enhance it, because after you have your orgasm, quite honestly, you don't have the loss of the erection.
DAVID R. MARKS, MD: The refractory period.
JOHN: So what you can do is you can control that.
DAVID R. MARKS, MD: Your partner is laughing now. Is your satisfaction as high as John's?
JOHN'S PARTNER: That's every guy's dream, I think. It's very natural, very normal. I find no difference, really, with it at all once you're used to it, and it's not even a matter of getting used to it. I'd say it's wonderful. It's worked really well.
DAVID R. MARKS, MD: The actual mechanics of it, though, when you have to actually fill the chambers when you use the pump, does it interfere with the flow of sex?
JOHN'S PARTNER: No.
DAVID R. MARKS, MD: Do you incorporate it into the process?
JOHN: I really don't feel that your partner has to even be aware. I know patients that have not told their partners that they have the pump, and it's very, very difficult to tell if you're not sharing that.
DAVID R. MARKS, MD: Jim, how about you? How satisfied are you?
JIM: Very much so. I have a very normal sex life. Before the operation, it's the same, and everything's fine.
DAVID R. MARKS, MD: François, how does this compare to some of the other treatments that are available for erectile dysfunction?
J. FRANÇOIS EID, MD: It's the only treatment that restores sexual spontaneity. I think I should say that first, because if you take Viagra you have to plan ahead. If you want Viagra to be effective, you have to take it on an empty stomach, so it becomes a problem, it becomes a scheduling problem when you want to have sex. If you do the penile injections, you have to, again, excuse yourself, go to the bathroom, give yourself a shot, so you have to plan.
DAVID R. MARKS, MD: Have people looked at patients who have had these implants over the long term and studied how satisfied they are?
J. FRANÇOIS EID, MD: Yes, there has been a multi-institutional study that looked at patients who were operated on in different centers across the United States, and they followed the patients for, I think it was six to seven years, and they found that the devices had an incredible reliability. Over 80% of these devices were lasting over five years, and the patients were extremely satisfied. But they also went further than that, and they asked the partner, and some of the partners, the satisfaction rate with the partner was actually higher than the patient himself.
DAVID R. MARKS, MD: There must be some downside to the procedure.
J. FRANÇOIS EID, MD: Every procedure may have side effects. Taking a pill has side effects. The side effects are infection and malfunction. With the experienced surgeon, these side effects are extremely unlikely. For example, in our group of patients, our infection rate is really well below 1%, so it's really less than half a percent, and the malfunction rate is about 2 to 3% at eight years, so it's extremely small.
DAVID R. MARKS, MD: John, tell me, you were satisfied how quickly? I mean, I know you are very satisfied now. How long did it take you to actually become satisfied, to become comfortable with the device? It is different than the way you were before. It takes a little more effort, I would assume.
JOHN: I was very cognizant of it, probably, the first six weeks, if that.
DAVID R. MARKS, MD: "Cognizant" meaning what? That you felt it, or mentally?
JOHN: Mentally, "I'm going to have sex, and I'm going to have an erection, and I have to create it." But it was, I wouldn't even say six weeks, because by the middle of the summer I wasn't even remembering that I had to go through this. It's spontaneous, and that's what's so beautiful about it. It's spontaneous, and it's so simple to initiate that it's not even, "Oh, my gosh, did I do this right? Did I do this wrong?" It's just so simplistic, it's not getting used to.
DAVID R. MARKS, MD: Jim, how about you? How long did it take to become comfortable? And what's the main difference now as compared to when you first had the device implanted?
JIM: Well, the main problem was not pumping. The main problem in the beginning was getting rid of the erection. I had a problem releasing it -- which is a problem that you want to have, really. But after several times it became just as natural to release the erection as to gain the erection.
DAVID R. MARKS, MD: And the main difference now compared to then? Is there any difference at all?
JIM: Well, the same as John says. It's so easy, 12, 14 squeezes of the pump, a few seconds, you don't even realize that you're doing it.
DAVID R. MARKS, MD: Orgasm feels normal?
JIM: Yes, it does.
DAVID R. MARKS, MD: John, completely normal?
JOHN: Yes.
DAVID R. MARKS, MD: Just like it was before?
JOHN: Yes.
DAVID R. MARKS, MD: And your partner would agree?
JOHN'S PARTNER: Yes. Totally normal. After a short time, you don't even think about it anymore. It's no longer mentally part of the whole equation. It's gone.
DAVID R. MARKS, MD: Guys, any final comments? John?
JOHN: I just would definitely pursue any concerns that you have as soon as you have them. Don't wait.
DAVID R. MARKS, MD: From a partner's standpoint, do you have any last thoughts for partners?
JOHN'S PARTNER: I think as far as a partner is concerned, they should just give absolutely their complete support of this procedure, and I think mentally, physically and everything it was wonderful for John and for me.
DAVID R. MARKS, MD: I want to thank you all for being here, and maybe we'll follow up with you another year and a half down the road or so and make sure you're doing well. Thank you for being here, too, Dr. Eid.
J. FRANÇOIS EID, MD: Thank you.
DAVID R. MARKS, MD: Thanks for joining our webcast. I'm Dr. David Marks. Goodbye.
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